Woman Helps Kids Cope With Hospital

TAMARAC — No mother ever expects to outlive her child. But seven years ago Marcia Cherniachovsky saw her worst fears realized when doctors discovered her daughter was suffering from leukemia.

Knowing Allison, then 3, could die, seeing her suffer from painful spinal taps and believing there was nothing she could do was too much to handle for Cherniachovsky, then an employee with the Consumer Affairs Institute of Miami.

``A number of my needs, as well as hers, were not being met,`` she said. ``Nobody ever talked about the trauma we went through.``

Eventually Allison went into remission, and the disease hasn`t appeared since. Yet the upheaval of facing death remained for both mother and daughter.

For Cherniachovsky the best therapy she could have for working out her fears was to try to help other parents in the same situation.

She learned more about helping parents cope, went back to school and now heads University Community Hospital`s Child Life Program, where kids and parents are prepared for the process of treatment.

The basic tools for this medicine are toys, located in a corner room on the hospital`s fourth-floor pediatrics ward.

There are dolls, puzzles, coloring books, video games, video recorders and music. But the program is not strictly for play.

Here children are sheltered from the normally hostile routine of a hospital. For a time they get a chance to remind themselves of home.

Parents are encouraged to bring a child`s favorite toys and a blanket, and tell workers what television programs the child might like.

There is a modus, however, to this room`s operandi. Cherniachovsky also wants the kids to play with special toys: dolls with bandages and broken arms, needles and stethescopes, microscopes and blood-pressure devices.

While treating another young girl, Cindy, for leukemia, Cherniachovsky gave her a doll, some play doctor`s needles and some other play medical toys.

``She took the syringe needle and then stabbed the baby doll over and over again,`` Cherniachovsky said. ``I told her what she was doing was wrong but she said, `I know, but I`m angry.` ``

By stabbing the doll -- re-enacting what she felt the doctors were doing to her -- Cindy was giving herself some control over the situation of being hospitalized.

``It might have been worse if she hadn`t gotten it out of her,`` Cherniachovsky said, adding that Cindy is now in remission.

Aside from pain, hospitalized children are hurt by the circumstances of their illness. Their safe, controlled home environment, where parents know and do everything, is removed. They often view the hospitalization as an invasion, both physically and emotionally.

``There`s always psychological trauma involved,`` Cherniachovsky said. ``The effect of a hospitalization can be worse than the illness. It can affect a child developmentally.``

Children feel guilty about being sick, she said, and they have to be told they`ve done nothing wrong.

Cherniachovsky said her unit treats patients from infants to 21 years of age. It is one of only three such programs in South Florida, the other two being at Children`s Hospital and Jackson Memorial Hospital, both in Miami.

Once the doctors have made their diagnosis and performed initial tests, Cherniachovsky goes to work in her corner room, where the kids have fun.

``I use the analogy of working with wallpaper,`` she said. ``If you put the paper up and there`s wrinkles in it, you have to smooth them out right away. If the paper dries it`s almost impossible to get them out.

``It`s the same with kids` fears. If you don`t work them out right away it`s tough to deal with them.``

Stephen Canu is a veteran of pediatrics wards.

Since last summer he has been hospitalized seven times for acute asthma. A few days after the July 4 holiday he had trouble breathing, and his mother, Marion, rushed him to University Community`s emergency ward.

Stephen spent a few days in intensive care before he was transferred to pediatrics.

On his first day in the Child Life Program, he watched cartoons and played with a toy needle. After breakfast, Cherniachovsky took him and his mother to the room and conducted the play therapy.

Stephen said he`d be the doctor, which is normal. ``When they ask to be the patient, then I`ve got problems,`` Cherniachovsky said. ``It means they`ve accepted their patient role as a victim.``

Cherniachovsky played the patient, who was suffering from a cold. She suggested Stephen give her a shot of medicine to help her.

Without any prodding, Stephen reached for a sterile gauze pad to wipe Cherniachovsky`s arm.

``This will make it better,`` Stephen said, applying the pad. His mother`s jaw dropped in shock that he knew the routine so well.